Taken from the Esperanza archives which can be found HERE.
When Catherine M. began spending time with her future husband, she and James spent hours talking, going to the movies, taking weekend trips and getting to know one another. It didn’t take long for James to tell his new love that he had depression.
He’d been diagnosed long before the couple started dating in 1996, and assured her that he managed his depression through medication and regular counseling sessions.
“When he talked about his depression, I recognized his strength and his desire to get help,” recalls Catherine, a nurse in Vancouver, British Columbia. “He was in a stable place. His depression was under control.”
The couple married in 2003 and easily weathered James’s sporadic depressive episodes and mild symptoms. Then James fell into a deep depression last year after losing his father and his job. The dark mood not only robbed James of his spontaneous nature and passion for travel, but also stole the husband Catherine knew and the satisfactions of their shared activities.
“We lost all of the things we used to do together,” notes Catherine, 65. “Our life became much smaller. I was getting worn down and didn’t know how to cope. It affected him, me and our relationship.”
Research shows that when one member of a couple has depression, there is a significant impact on the well-being of the other partner. Research published in BMC Public Health in August 2010 found that spouses of those with mental illnesses, including depression, were more apt to exhibit signs of anxiety and depression themselves.
“Depression doesn’t just impact the person with the diagnosis, it impacts their [partner], too,” points out Lynne Knobloch-Fedders, PhD, a licensed clinical psychologist and director of research at The Family Institute at Northwestern University.
Research also points to depression’s impact on the relationship. For example, a two-year study of the association between marital discord and depressive symptoms, published in the journal Psychology and Aging in March 2009, found lower levels of marital satisfaction among spouses of people who were depressed.
A team approach works best when addressing dissatisfaction and conflict connected to one partner’s depression. Says Knobloch-Fedders, “It’s important not to think of depression as an individual problem but as both people’s problem. The research in this area is clear: When depression negatively affects the relationship, it is much more effective when both partners are involved in the treatment.”
It’s not uncommon for the partner of some- one with depression to mirror symptoms such as hopelessness, fatigue, anxiousness and low self-image, experts say.
“When the partner with depression suddenly switches from warm and loving to withdrawn and critical, the non-depressed partner tends to assume the change is somehow their fault,” explains Anne Sheffield, author of Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond (Harper Paperbacks, 2003) and How You Can Survive When They’re Depressed: Living and Coping with Depression Fallout (Three Rivers Press, 1999).
“Unrewarded attempts to restore the relationship lead to demoralization and frustration,” Sheffield continues, and such feelings “might lead the non-depressed partner to give up—or fall into depression themselves.”
Sheffield has depression, as do her mother and daughter. She believes that individuals who love a person with depression may come to feel guilty because their love and support are not enough to heal the other person.
Jeanne H. experienced those feelings of powerlessness when her partner, Ana Maria K., started showing signs of depression last spring after a long-distance move to Seattle and prolonged job search. It was the first time Ana Maria’s depression had surfaced in their 13-year relationship.
“I feel so much guilt,” says Jeanne, 41, reflecting on her inability to make Ana Maria feel better and heal their relationship.
Jeanne wanted nothing more than to help her partner. She suggested long walks, outings to favorite restaurants and weekend escapes in hopes of lightening Ana Maria’s dark mood. Nothing worked.
As Ana Maria fell deeper into depression despite medication and regular counseling sessions, Jeanne took over household responsibilities that the couple once shared. She skipped workouts and declined social invitations in order to be at home in case Ana Maria needed her.
“I was doing all I could for her and it wasn’t helping,” Jeanne recalls. “It started to drag me down.”
It also dragged down their relationship. The couple spent less time together, their conversations were strained, and intimacy was out of the question.
Jeanne also felt guilty for wishing their relationship could return to normal.
“I told my therapist, ‘I’m not getting anything from this relationship,’ and then I felt horrible for admitting that,” she recalls.
Ana Maria made the difficult decision to move in with her parents as her depression worsened. Jeanne says their relationship “is in a crisis situation,” but they haven’t given up.
Jeanne and Ana Maria turned to counseling, together and individually, to cope with the fallout of Ana Maria’s depression. In their couples counseling sessions, the pair works on improving communication and rebuilding their intimate connection.
“[Couples counseling] can give partners the right language to talk to each other,” notes Dave Gallson, associate national executive director of the Mood Disorders Society of Canada. “A therapist can help both partners identify boundaries, set limits and talk about depression and its impact on the relationship in non-critical ways.”
As for her individual therapy, Jeanne believes the one-on-one support has been instrumental in helping her deal with feelings of guilt, rejection, fear and loneliness that arose in response to Ana Maria’s depression—and in giving her tools to respond to Ana Maria’s symptomatic behavior.
“I needed to figure out how to deal with things better,” she explains. “Now, if there’s a negative conversation, I stop and notice and realize that I have a choice in how I react. I’m more mindful, and it’s helped a lot.”
Learning more about the causes of depression, and the behavior and feelings that arise from the illness, is key for the partner without depression, says Anne Sheffield. She and other experts also laud the benefits of peer support available online and through mental health organizations and other groups.
“You need a place to share experiences with people who understand,” says Sheffield. “Support groups help you realize that you’re not alone, and can offer a great sense of security that there is a solution and you can get through this.”
That’s what helped Lisa G. after her husband, Fred, was diagnosed with depression in 2006. She felt overwhelmed by the emotional upheaval and practical responsibilities such as scheduling medical appointments, coordinating communication among his doctors, and filing insurance paperwork. At times her husband’s outlook was so bleak she had to write a list reminding him to bathe, eat and take his medication.
“For a long time, I wasn’t sure he was going to get better. The change was so dramatic and … I had no idea how to cope,” recalls Lisa, 52, a wellness coach from Branford, Connecticut.
Through the Family-to-Family program of the National Alliance on Mental Illness, she learned more about the nature of depression and how to navigate the challenges of living with someone who is depressed. She also met others who understood her grief and frustration, and shared tips on how to manage day-to-day.
“It was so helpful to know that I wasn’t alone,” she says, “that there were other people who were going through similar things.”
Fred, 57, still grapples with depression and his illness has been difficult on their marriage, but Lisa accepts the new challenges as part of their lifetime commitment to each other.
“Just because someone has a mental illness doesn’t mean it defines the relationship or the future,” she asserts. “It was something we didn’t plan and it’s been hard, but I’ll never give up on him.”
A team approach
Embracing a “we are in this together” attitude not only improves treatment outcomes for the person with depression, experts say, but can even make the relationship stronger.
“Both partners have to get educated about the disease and understand how it can impact the relationship,” says Gallson. “Depression can’t be addressed alone. One person cannot be the cure.”
Taking a team approach also may avert a phenomenon called “compassion fatigue,” says Mitch Golant, PhD, a health psychologist and co-author of What to Do When Someone You Love is Depressed (Holt, 2007).
“The non-depressed partner will start to take on some of the hopelessness their partner is showing and will start to become depressed, critical and fatigued,” explains Golant. “To avoid this kind of burnout, it’s important to view depression as something to deal with together, not something to handle all alone.”
Jason S., 39, believes that even though his wife, Shelle, is the one with the diagnosis of depression, managing her illness is a shared responsibility.
“It’s not something I can fix, but that doesn’t mean I can’t be helpful,” explains Jason, who has known about Shelle’s depression since they started dating in 2006.
Jason takes cues from his wife, using humor or suggesting trips to the bookstore when she seems to need a pick-me-up, listening and offering advice when she is sharing frustrations, and canceling plans to spend a quiet night at home when Shelle has bouts of social anxiety.
Jason also attends medical appointments with Shelle, taking an active role in describing her symptoms to doctors and ensuring she follows treatment plans at home.
“It feels good for me to support her,” says Jason, an information technology professional from Little Rock, Arkansas. “[Shelle] has expressed to me that she appreciates me being there for her, and I think going through this together has made our relationship stronger.”
That attitude in a partner turns depression from a drain on the relationship into another source of connection, according to Knobloch-Fedders. When couples seek joint solutions—through couples counseling or other resources—they may improve the way they communicate, learn how to work together to address issues arising from the depression, and reaffirm their commitment to the relationship.
In turn, a body of research (surveyed in the July 2009 issue of Aging & Mental Health) suggests that better communication skills and joint problem-solving moderates risk factors for depression—ultimately reducing the stress that depressive episodes place on the relationship and the other person.
Catherine M. admits that her husband’s ongoing depression puts stress on her and their marriage. She’s careful to take time for herself and draws strength from close friends, but at times she’s reduced to tears by the situation. Still, she also sees a positive outcome.
“[His depression] has led us to have good conversations about his illness and our relationship, and we feel much closer when we have those conversations,” explains Catherine, adding, “Even when it’s difficult, I know that no one can make me laugh like he can and that’s a wonderful thing. If I had to do it all over again, I wouldn’t change my decision to marry him.”
Jodi Helmer is a freelance writer in Charlotte, North Carolina. Her work has appeared in Shape, Women’s Health, Family Circle and other national magazines.
SIDEBAR: Resisting the ripples
When a partner is depressed, these tips from Families for Depression Awareness can help keep your own mental health in balance:
Remember it’s not your fault. Depression in your partner is a medical condition, not the result of something you said or did.
Recognize normal reactions. Along with compassion for your partner, don’t be surprised to feel frustration, anger, and even hatred. It is extremely difficult not to take symptoms such as withdrawal and irritability personally. Also common are resentment because your life has changed and grief because the person you love seems to be gone. Don’t be afraid to seek counseling to deal with your emotions.
Don’t be a martyr. No matter how hard it seems, be sure to schedule time for activities that you enjoy. If you are taking on extra responsibilities around the house or in overseeing your partner’s treatment, look for other family members, friends, or even service professionals (a housecleaner, for example) who can take on some tasks.
Find social support. Dealing with depression in a partner can be isolating. Make the effort to spend time with friends who are able to sympathize and provide emotional sustenance. Seek out peer support groups for families of people with depression.
Be part of the solution. Learning more about depression and how to provide useful support—as well as knowing what not to do—can improve treatment outcomes for your partner. The better your partner gets, the more pressure that takes off you and your relationship. Couples counseling helps address issues arising from the depression.
Have hope. You may feel rejected and discouraged when nothing you do to help your partner seems to work. Keep in mind that depression is often cyclical—worse at times, easier to manage at others—and finding the right treatment may take time. And remember that 80 percent of people with depression improve with treatment.